In an unpublished opinion released on November 29, 2014, the Minnesota Court of Appeals overturned the lower court’s dismissal of a wrongful death medical malpractice lawsuit involving the transplantation of a pancreas from a donor who unknowingly had cancer into a woman who subsequently contracted cancer from the diseased pancreas and died. The lower court had determined as a matter of law that it was not foreseeable that the decedent would contract cancer from a transplanted organ and thus the defendant doctor did not breach the standard of care, and the alleged breach was not the proximate cause of the decedent’s death.
The Minnesota Court of Appeals held that there were genuine issues of material fact as to both the standard of care and causation, and therefore the lower court had erred.
The decedent died of T-cell lymphoma after she received a pancreas from an organ donor who had the disease. Neither the donor’s treating doctors nor the decedent’s doctor knew that the donor had cancer before the transplant. The plaintiff’s Minnesota medical malpractice wrongful death lawsuit alleged that the decedent’s doctor was negligent in accepting the pancreas for transplantation into the decedent because the donor was a 15-year-old whose cause of death was thought to be bacterial meningitis but no causative organism for bacterial meningitis had been discovered by the donor’s doctor (confirming that the donor’s meningitis was bacterial was important as to whether to accept the pancreas because viral meningitis was a relative contraindication for a pancreas transplant).
Over a month after the donor’s death (he had been ill for one month before he died), an autopsy revealed that the donor died due to T-cell lymphoma and not due to bacterial or viral meningitis. The donor pancreas was then removed from the recipient but not before the cancer had spread to her (the removed pancreas was found to have cancer cells).
The plaintiff filed an expert witness affidavit as required by Minn. Stat. § 145.682 (2012), which stated that the plaintiff’s medical expert would testify that the standard of care governing physicians and other health care professionals engaged in organ transplant surgery requires that an organ offered for transplant not be accepted unless and until it has been determined that the organ likely is safe and suitable for transplantation, and further stated that it was a breach of the standard of care by the defendant doctor not to have reviewed the relevant portions of the medical records relating to the illness that led to the death of the donor, to not confirm the cause of death, and to have accepted the organ when the donor’s objective test results and clinical presentation strongly suggested his cause of death was not the result of bacterial meningitis and, consequently, was unknown.
In analyzing the defendants’ motion for summary judgment, the lower court reasoned that the donor’s diagnosis at the time of the transplant surgery was neither unknown nor uncertain and that the final diagnosis was bacterial meningitis although earlier physicians thought it was viral meningitis. The Minnesota Court of Appeals held that to the extent that the lower court determined that the donor had bacterial meningitis at the time of his death, the lower court engaged in impermissible fact-finding at the summary judgment stage of proceedings.
The Minnesota Court of Appeals also held that the lower court erred when it determined that the defendant doctor did not violate the standard of care because it was not foreseeable that the donor had T-cell lymphoma, in light of the plaintiff’s expert affidavit that the defendant doctor breached the standard of care by accepting the donor’s pancreas because it could not be confirmed that the donor had bacterial meningitis, and there was a risk that the donor had viral meningitis or some other illness that would make the pancreas unsuitable for transplantation.
The Minnesota Court of Appeals stated that negligence is tested by foresight but proximate cause is determined by hindsight and that the defendant doctor’s decision to accept the pancreas for transplantation was a substantial factor in bringing about the recipient’s death – the fact that the particular injury was not foreseeable does not preclude a finding of proximate cause (“If a person had no reasonable ground to anticipate that a particular act would or might result in any injury to anybody, then, of course, the act would not be negligent at all; but, if the act itself is negligent, then the person guilty of it is equally liable for all its natural and proximate consequences, whether he could have foreseen them or not”).
The Minnesota Court of Appeals stated, “Liability in this case will turn not on causation, but on whether [the defendant doctor] violated the standard of care in accepting the donated pancreas for transplantation into [the decedent]. Respondents do not challenge appellant’s affidavit of expert review on the basis that it fails to set forth the standard of care and [the defendant doctor’s] conduct that is alleged to have breached that standard. Nor, based on our analysis above, could they succeed in such a challenge. Accordingly, we conclude that the district court abused its discretion by granting dismissal for failure to comply with Minn. Stat. § 145.682.”
Source Kimberly Shierts, Trustee for the Heirs of Jodi Shierts v. University of Minnesota Physicians, et al., A14-0334.
If you or a loved one suffered serious injury or other harms as a result of medical negligence involving an organ transplant in the United States, you should promptly consult with a transplant malpractice lawyer in your state who may investigate your transplant malpractice claim for you and represent you in a medical malpractice transplant case, if appropriate.
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